side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

> Adderall

US brand name: Adderall
Generic name: dextroamphetamine and amphetamine

Other Forms: Extended-release Adderall-XR, which is the default for Adderall these days. The immediate-release form is still available as both brand and generic.

Class: Stimulants

1.  Other brand names & branded generic names1

I think there are more generic names for Adderall than all the transliterated crazy med generics in Finland. The only reason I use dextroamphetamine and amphetamine is because it’s the shortest with any form of precision.

2.  FDA Approved Uses of Adderall XR (dextroamphetamine and amphetamine)

  • Attention Deficit Hyperactivity Disorder in adults and children age 6 and older.

3.  FDA Approved Uses of Immediate-Release Adderall (dextroamphetamine and amphetamine)

  • Attention Deficit Hyperactivity Disorder in children age 6 and older, but not adults.
  • Narcolepsy

4.  Off-Label Uses of Adderall

5.  Adderall’s pros and cons

5.1  Adderall’s Pros

  • A tried and true way to treat ADD/ADHD and narcolepsy.
  • The go-to med for severe ADHD.
  • Because it’s an amphetamine it has a low side effect profile.

5.2  Adderall’s Cons

  • Those triplicate prescriptions are a pain in the ass to deal with.
  • If you have any history of drug abuse, the odds are you’ll never get an Adderall prescription no matter how much you’ve cleaned up your act and how helpful it will be to you.
  • Because it’s an amphetamine it might be a little too much fun to use for some people.

6.  Adderall’s Side Effects

6.1  Typical Side Effects

The usual for stimulants:

  • headache
  • nausea
  • dry mouth
  • sweating
  • insomnia
  • constipation
  • weight loss
  • heart palpitations
  • raised blood pressure
  • dizziness
  • horniness

Generally everything clears up after a couple weeks except the constipation, weight loss, increased blood pressure and increased libido. So unless you have blood pressure issues and/or real problems with being too thin and/or too horny already I’m sure you can live with the typical side effects.

6.2  Not So Common Side Effects of Adderall

Triggering a manic reaction. More often than not this happens when someone is misdiagnosed as only having ADD/ADHD when they are also bipolar. For the longest time you couldn’t find “manic reaction” as a side effect anywhere in the PI sheet, just every symptom of mania listed instead. Apparently someone else noticed that great CYA (Cover Your Ass) move by Shire and complained to the right people. Shire now recommends screening for bipolar disorder. About time they did the right thing.

Other not-so-common side effects are:

  • tics
  • twitches
    • general exacerbation or unmasking of Tourette’s or similar syndromes
  • depression
  • screwing with your menstrual cycle

6.3  Adderall’s Freaky Rare Side Effects

Amphetamines don’t have much in the way of side effects, let alone freaky rare side effects. The closest thing I can find is the combination of increased libido and impotence, which you can also get from Wellbutrin.

7.  Interesting Stuff Your Doctor Probably Won’t Tell You about Adderall

  • Lithium prevents Adderall from working. Giving lithium carbonate to lab rats who were jacked up on amphetamines and watching them mellow out is how scientists back in the 1970s confirmed that lithium probably does work for bipolar disorder.
  • Mixing booze and Adderall, or any stimulant, is a really bad idea. Not only do you increase the chances of having a seizure of some kind (even if you’ve never had one before), but you just don’t feel quite so drunk. So you have another. And another. And another. Until you’re a lot thinker than you’re drunk, and still insist on driving home, what do you mean it’s not your car?
  • Your doctor, or at least your pharmacist should tell you not to wash down your Adderall with orange juice or any other fruit juices. Those severely lower the absorption of amphetamines. You can drink fruit juice at other times of the day, just not around when you’re taking your speed.
    • The same goes for vitamin C supplements
  • On the flip side, you need to avoid taking antacids at the same time as Adderall, as that can cause you to wind up getting more than you expected.
  • Adderall is one of the few drugs that is referred to by brand name far more often than by its generic name in the literature. Why? Probably because no one can agree on exactly what the generic name is. I’m going with “dextroamphetamine and amphetamine” because it’s short and more precise than the somewhat shorter “mixed amphetamine salts.”

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8.  Adderall’s Dosage and How to Take Adderall

With all stimulants the drug companies and I are in full agreement - start at the lowest possible dosage and see what works! Here it is, right in the PI sheet:

Individualize the dosage according to the therapeutic needs and response of the patient. Administer ADDERALL XR at the lowest effective dosage. Adderall XR PI sheet

I prefer the wording for immediate-release Adderall:

Regardless of indication, amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted. Late evening doses should be avoided because of the resulting insomnia. immediate-release Adderall PI sheet

8.1  ADD/ADHD in Adults

Adderall was originally approved for childhood ADD/ADHD and all the guidelines were just for kids, so they would start you out at 5mg once or twice a day. With the XR version that would be one 10mg capsule a day. And I’m really down with that method. Now the PI sheet has adults starting at 20mg a day no matter what. You know, they make 5mg and 10mg capsules and everything costs the same, so why not start at 10mg, or even 5mg a day and see how that goes at first? It’s easier to deal with having to take more Adderall if it’s not working well enough than to deal with the side effects of having had too much to start with. If required increase your by 5–10mg a day, giving it at least a week between each increase.

The maximum dosage for an adult is 60mg a day. For kids it’s 30mg a day.

Adderall XR is taken once a day, with or without food, preferably in the morning (or whatever time of day it is when you’re supposed to wake up). Immediate-release Adderall is taken twice a day.

8.2  Narcolepsy

Only immediate-release Adderall is approved for narcolepsy, so it’s start with the lowest dosage possible - one 5mg tablet twice a day. If required, increase your dosage by 5–10mg a day per week. As with ADD/ADHD the maximum dosage for an adult is 60mg a day. Adderall should be doing something positive for you long before then. If you’re taking 40mg of Adderall a day, still taking unwanted power naps randomly through the day, and looking like the winner of the Miss Anorexia contest, you should be discussing another med with your doctor.

8.3  Depression

These days using Adderall or other stimulants for depression is pretty radical, but not unheard of. They are sometimes the only thing that will work. Good luck in finding a doctor who will actually work with you along these lines if you need to go this route. Again you should start at the lowest possible dosage. I don’t have a clue if the maximum dosage of Adderall for depression is lower than 60mg a day or not. This is the sort of thing most doctors don’t want to write about. In Essential Psychopharmacology: Neuroscientific Basis and Practical Applications Stahl writes about using amphetamine along with MAOIs to treat depression that refuses to respond to anything else. Which has to be really tricky, because amphetamine is an MAOI itself, albeit a mild one.

9.  How Long Adderall Takes to Work

You should start feeling results within hours of taking your first dose. You might not get over your ADD/ADHD or narcolepsy symptoms immediately, but you’ll certainly feel something. This is all part of the art of psychopharmacology combined with whatever therapy you’re getting and coping skills you’re learning. It’ll all be a matter of finding the right dosage and learning to work with this med. Presuming Adderall is the right drug for you in the first place.

10.  How to Stop Taking Adderall

Your doctor should be recommending that you reduce your dosage by 10–20mg a day every three days if you need to discontinue it. The symptoms of amphetamine withdrawal syndrome - panic, nausea, agitation, insomnia, depression, and an overall sense of helplessness - are unpleasant, but if whatever you’re experiencing sucks more than all those, sudden discontinuation rarely causes any severe problems. Unless you were taking 50–60mg a day for several years.

So if you’re at 60mg a day you take 50mg a day for three days, then 40mg a day for the next three days and so forth until done.

11.  Adderall’s Half-Life & Average Time to Clear Out of Your System

The half-lives of Adderall’s two main components, dextroamphetamine and amphetamine are, respectively, 11 and 13 hours in adults. So call it three days.

12.  Days to Reach a Steady State

Usually two to three days.

13.  How Adderall Works

Although it predates it, amphetamine is like Wellbutrin on steroids. Like Wellbutrin Adderall is a norepinephrine and dopamine reuptake inhibitor. Not only that, amphetamine shoves the dopamine and norepinephrine into your neurons faster and encourages your brain to pump out more of those tasty neurotransmitters. Why that works for ADD/ADHD is actually fairly well understood, as the Communications Interference Hypothesis of psychiatric and neurological conditions, is generally accepted for ADD/ADHD. Basically you’re not getting enough and/or your brain isn’t properly processing dopamine and norepinephrine in specific parts of your brain, with different areas corresponding to the different types of ADD/ADHD. Adderall, other stimulants, Wellbutrin and Strattera correct that imbalance or compensate for your lazy ass brain.

How Adderall works for narcolepsy is purely brute force. Unlike Provigil (modafinil) and Nuvigil (armodafinil)

14.  Shelf-Life

Two years? I could find the shelf-life for the dextroamphetamine component only.


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16.  Adderall Ratings, Reviews, & Other Sites of Interest

Adderall Ratings & Reviews Page.

16.1  Rate Adderall

Give your overall impression of Adderall on a scale of 0 to 5. Detailed ratings and reviews are available on the Adderall Ratings & Reviews Page.

Get all critical about Adderall

4.5 stars Rating 4.2 out of 5 from 75 criticisms.
Vote Distribution: 2 – 1 – 6 – 4 – 21 – 41

16.2  Rate this article

If you’re still feeling judgmental as well as just mental2, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Adderall (dextroamphetamine and amphetamine) Synopsis

5 stars Rating 4.5 out of 5 from 42 value judgments.
Vote Distribution: 0 – 0 – 1 – 3 – 10 – 28

16.3  Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, check for drug-drug interactions

Adderall’s Full US Prescribing Information / PI Sheet

Full US PI sheet for immediate-release Adderall’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.

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16.4  Discussion board

If you have any questions not answered here, please see the Crazymeds Adderall discussion board.

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17.  Bibliography

Full US PI sheet for Adderall XR
Full US PI sheet for immediate-release Adderall
Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition by Stephen M. Stahl © 2008 Published by Cambridge University Press.
Primer of Drug Action 12th edition by Robert M. Julien Ph.D, Claire D. Advokat, Joseph Comaty © 2011 Published by Worth Publishers.
Clinical Handbook of Psychotropic Drugs 18th edition Adil S. Virani, K. Bezchlibnyk-Butler, J. Jeffries © 2009 Published by Hogrefe & Huber Publishers.

Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier. Also the 2004 edition, but only on pages that haven’t been fully updated yet.

Instant Psychopharmacology 2nd Edition Ronald J. Diamond MD © 2002. Published by W.W. Norton
The Complete Guide to Psychiatric Drugs Edward Drummond, MD © 2000. Published by John Wiley & Sons, Inc.
PDR: Physicians’ Desk Reference 2010 64th edition back through to 53rd edition of 1999. Old copies of the PDR come in handy for PI sheets that are no longer available and difficult to find, as well as to track the changes in both indications and adverse effects.
Healing ADD: The Breakthrough Program That Allows You to See and Heal the 6 Types of ADD Daniel G. Amen, M.D. © 2002. Published by G.P. Putnam’s Sons.

1 The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin, and they are owned by Pfizer, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions.

2 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

If you have any questions not answered here, please see the Crazymeds Adderall discussion board. I welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why I write these damn things. I’m frustrated enough as it is. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds.

Last modified on Thursday, 27 March, 2014 at 12:57:48 by SomeMedCriticPage Author: JerodPooreDate created Saturday, 08 September, 2012 at 17:10:20

Adderall by JerodPoore is copyright © 2012 JerodPoore

Adderall, and all other drug names on this page and use throughout the site, are a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.

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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
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‘Everything is true, nothing is permitted.’ - Jerod Poore

1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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